Michele Ojeda-White
Fraud Investigator
Turlock,CA
Summary
Dynamic and results-oriented professional with extensive experience in fraud investigation and auto damage assessment, notably with GEICO. Excelled in reducing fraudulent activity through innovative detection strategies and meticulous case management. Demonstrated exceptional communication and problem-solving abilities, fostering team collaboration and enhancing customer satisfaction. Skilled in investigative techniques and adept at adapting to complex situations, consistently achieving targets.
Overview
29
29
years of professional experience
Work History
Fraud Investigator
GEICO
- Performed detailed background checks on individuals suspected of fraudulent activity to gather critical information needed for successful investigations.
- Provided exceptional customer service to clients affected by fraudulent activities, addressing their concerns while maintaining compliance with regulatory guidelines.
- Maintained a high level of confidentiality when handling sensitive information, protecting both company reputation and client privacy.
- Conducted prompt and thorough investigations on referred files.
- Reduced fraudulent activity by implementing effective fraud detection strategies and tools.
- Kept current with industry best practices and attended professional development events to maintain expertise in fraud investigation techniques.
- Streamlined investigation processes by developing efficient case management techniques, reducing time spent on each case without sacrificing accuracy or effectiveness.
- Monitored account activity in real-time for early detection and swift resolution of potential issues before they escalated into significant losses for the organization.
- Interviewed witnesses thoroughly, asking appropriate questions to ascertain critical details about each case.
- Summarized all key information regarding investigation into detailed report for delivery to client.
- Served as a mentor to junior investigators, sharing knowledge and expertise while fostering a collaborative team environment.
- Reviewed reports and individual transactions which appeared suspicious to uncover possible fraudulent activity.
- Collaborated with team members to discuss fraud trends and brainstorm methods to combat this type of crime.
- Analyzed financial statements to identify discrepancies, irregularities and fraudulent activity.
- Reviewed transactions and receipts to identify any suspicious activity.
Auto Damage Adjuster
Bristol West Insurance Group
07.2000 - 05.2007
- Strengthened team performance by sharing knowledge and expertise on industry best practices for auto damage adjusting.
- Reduced fraudulent claims through thorough investigations and detailed documentation.
- Provided expert guidance to junior adjusters, helping them develop essential skills for success in the role.
- Demonstrated versatility in adapting approach based on individual claim complexity or unique circumstances that may arise during handling.
- Served as a trusted resource within the team, providing support and guidance for colleagues when faced with challenging situations or complex claims.
- Improved customer satisfaction by efficiently addressing and resolving auto damage claims.
- Leveraged strong negotiation skills when working with external partners such as body shops or salvage vendors.
- Managed a large caseload of auto damage claims, ensuring prompt resolution while maintaining high-quality standards in all aspects of handling each case.
- Maintained positive relationships with policyholders, providing exceptional customer service throughout the claims process.
- Negotiated fair settlements with claimants, balancing their needs with company interests.
- Collaborated with repair shops to ensure accurate estimates and quality repairs for clients.
- Consistently met or exceeded performance targets related to claim cycle time, accuracy, and customer satisfaction scores.
- Updated client records diligently, ensuring accurate information for future reference and communication.
- Coordinated with other departments to address any issues related to coverage or policy interpretation.
- Developed ongoing professional development plans to stay current on industry trends and regulatory changes.
- Conducted comprehensive vehicle inspections to accurately assess damage and determine repair costs.
- Enhanced claim processing times by streamlining workflow and prioritizing tasks effectively.
- Proactively communicated with clients throughout the claim process, setting clear expectations and delivering updates as needed.
- Documented all findings in concise reports.
- Negotiated with claimants to settle claims.
- Issued payouts to claimants.
- Examined photographs and surveillance and any other documents relating to claims.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
- Successfully negotiated settlements with claimants and insurers.
- Created detailed assessments of damages to property and vehicles.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
- Identified suspicious claims, escalating issues to supervisor for further investigation and analysis.
- Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
- Kept current on insurance regulations, laws, policies and procedures.
Body Shop Advisor
Ray Starn, Inc
03.1985 - 07.2000
- Enhanced customer satisfaction by providing accurate estimates and explaining repair processes thoroughly.
- Assisted in the development of marketing materials to promote the body shop''s services and special offers.
- Negotiated favorable terms with vendors supplying paint products, replacement parts, and other necessary items.
- Improved communication between technicians and customers, addressing concerns and ensuring timely updates on repair progress.
- Resolved customer complaints promptly and professionally, maintaining the company''s reputation for excellence in service.
- Reduced turnaround time for vehicle repairs with effective scheduling and prioritization of tasks.
- Managed inventory effectively, maintaining adequate stock levels for commonly used repair parts.
- Stayed up-to-date on industry trends and advancements in repair techniques, sharing knowledge with team members to ensure continuous improvement.
- Oversaw quality control measures throughout the repair process, guaranteeing consistent results meeting or exceeding expectations.
- Increased repeat business through exceptional customer service and follow-up calls postrepair.
- Collaborated with insurance companies to expedite claims processing for clients'' convenience.
- Maintained detailed records of all repair orders, guaranteeing accurate billing and tracking of completed work.
- Streamlined workflow for increased efficiency by implementing a well-organized parts ordering system.
- Established a welcoming environment within the body shop reception area to enhance client comfort during appointments.
- Conducted regular safety inspections within the facility, ensuring compliance with industry standards and regulations.
- Coordinated efforts with other departments within the dealership to optimize cross-functional collaboration and smooth operations.
- Inspected vehicles to identify and document repair needs.
- Inspected new parts and areas of repair to verify correctness and quality.
- Prepared cost estimates for vehicle repairs and provided detailed documentation for customer review.
- Enforced compliance with safety regulations when operating equipment.
- Evaluated OEM manufacturer schematics and service documentation to identify parts to order.
- Created and reviewed work orders detailing required repairs per shop and manufacturer guidelines.
- Maintaining shop inventory according to set standards and rectified discrepancies.
- Examined vehicles to determine extent of damage and repairs required.
- Inspected completed repairs for accuracy, quality and safety.
Education
Thomas Downey High School
Modesto, CASkills
- Fraud prevention
- Report filing
- Criminal Investigations
- Insurance fraud
- Investigative techniques
- Interviewing capabilities
- Evidence collection
- Case assignment oversight
- Fraud Detection
- Verbal and written communication
- Case Management
- Telephone and email etiquette
- Effective Communication
- Trained in Software
- Fraud patterns
- Insurance confirmation
- Ethical standards
- Fraud identification
- Report Preparation
- Investigation documentation
- Witness interviewing
- Problem-Solving
- Time Management
- Attention to Detail
- Problem-solving abilities
- Multitasking Abilities
- Reliability
- Excellent Communication
- Organizational Skills
- Adaptability and Flexibility
- Decision-Making
- Detail Oriented
- Team building
- Self Motivation
- Time management abilities
Timeline
Auto Damage Adjuster
Bristol West Insurance Group
07.2000 - 05.2007
Body Shop Advisor
Ray Starn, Inc
03.1985 - 07.2000
Fraud Investigator
GEICO
Thomas Downey High School
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